Transitions through stages of alcohol involvement: The potential role of mood disorders

Rosa M Crum; Kerry M Green; Elizabeth A Stuart; Lareina N La Flair; Marc Kealhofer; Andrea S Young; Noa Krawczyk; Kayla N Tormohlen; Carla L Storr; Anika A H Alvanzo; Ramin Mojtabai; Lauren R Pacek; Bernadette A Cullen; Beth A Reboussin

doi:10.1016/j.drugalcdep.2018.02.027

Transitions through stages of alcohol involvement: The potential role of mood disorders

Drug Alcohol Depend. 2018 Aug 1:189:116-124. doi: 10.1016/j.drugalcdep.2018.02.027. Epub 2018 Apr 10.

Authors

Affiliations

¹ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA. Electronic address: rcrum1@jhu.edu.
² Department of Behavioral and Community Health,University of Maryland College Park School of Public Health, 4200 Valley Dr. #2242, College Park, MD 21742, USA.
³ Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA.
⁴ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA.
⁵ Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA.
⁶ Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA; Department of Family and Community Health, University of Maryland School of Nursing, 655 W. Lombard St., Baltimore, MD 21201, USA.
⁷ Division of General Internal Medicine, Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA.
⁸ Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA.
⁹ Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA.
¹⁰ Department of Biostatistical Sciences, Wake Forest School of Medicine, 475 Vine St, Winston-Salem, NC 27101, USA.

Abstract

Introduction: Although prior clinical and population-based studies have demonstrated comorbidity between mood and alcohol use disorders (AUD), there is a paucity of research assessing whether mood disorders predict transition across stages of alcohol involvement.

Method: Hypothesizing that mood disorders predict transition across sex-specific alcohol involvement stages, we used prospective data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative survey of US adults, which included male (n = 14,564) and female (n = 20,089) participants surveyed in 2001-2 and re-interviewed in 2004-5. Latent class (LCA) and latent transition analyses (LTA) were used to assess patterns of alcohol involvement in the US and the association of lifetime mood disorders at baseline with transition across stages of alcohol involvement during follow-up.

Results: A three-class model of AUD criteria was identified (No problems, Moderate problems and Severe problems) for both sexes. Positive cross-sectional associations between mood disorder and problem classes of alcohol involvement were found among both sexes, as were positive longitudinal associations. Propensity score adjustment mitigated the associations of baseline mood disorder with progressive transition for both sexes. However, among females, baseline mood disorder was consistently associated with reduction in remission from Severe to Moderate alcohol problems (aOR = 0.30, CI = 0.09-0.99, p = .048) over time.

Discussion: Our study provides evidence that mood disorders impact transition through stages of alcohol involvement and are most strongly associated with hindering remission among females. Findings advance our understanding of these comorbid relationships and have clinical implications for ongoing assessment of drinking patterns among individuals with mood disorders.

Keywords: Abuse; Alcohol; Dependence; Depression; Latent transition analysis; Major depressive disorder.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Alcohol-Related Disorders / diagnosis
Alcohol-Related Disorders / epidemiology*
Alcohol-Related Disorders / psychology*
Comorbidity
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
Mood Disorders / diagnosis
Mood Disorders / epidemiology*
Mood Disorders / psychology*
Prospective Studies
Surveys and Questionnaires
United States / epidemiology
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding